Disease prediction of symptoms against laboratory diagnosis (95% CI) of reproductive tract infections
| Sensitivity | Specificity | PPV | NPV | |||||
|---|---|---|---|---|---|---|---|---|
| n | % (95% CI) | n | % (95% CI) | N | % (95% CI) | n | % (95% CI) | |
| Bacterial vaginosis | ||||||||
| Heavy menstruation | 7/93 | 7.5 (3.1 to 14.9) | 391/417 | 93.8 (91.0 to 95.9) | 7/33 | 21.2 (9.0 to 38.9) | 391/477 | 82.0 (78.2 to 85.3) |
| Between menses bleeding | 4/93 | 4.3 (1.2 to 11.0) | 401/417 | 96.2 (93.8 to 97.8) | 4/20 | 20.0 (5.7 to 43.7) | 401/490 | 81.8 (78.1 to 85.2) |
| Burning urine | 2/93 | 2.2 (0.3 to 7.6) | 408/417 | 97.8 (95.9 to 99.0) | 2/11 | 18.2 (2.3 to 51.8) | 408/499 | 81.8 (78.1 to 85.1) |
| Frequency of urine | 4/93 | 4.2 (1.2 to 10.4) | 408/417 | 97.8 (95.9 to 99.0) | 4/13 | 30.8 (9.1 to 61.4) | 408/497 | 82.1(78.2 to 85.3) |
| Abdominal/vaginal pain | 10/93 | 10.7 (5.3 to 18.9) | 382/417 | 91.6 (88.5 to 94.1) | 10/45 | 22.2 (11.2 to 37.1) | 382/465 | 82.2 (78.4 to 85.5) |
| Pain during intercourse* | 1/6 | 16.7 (0.5 to 64.1) | 39/40 | 97.5 (86.4 to 99.9) | 1/2 | 50.0 (1.3 to 98.7) | 39/44 | 88.6 (75.4 to 96.2) |
| Itchy/sore vagina† | 7/92 | 7.6 (3.1 to 15.1) | 397/412 | 96.4 (94.1 to 98.0) | 7/22 | 31.8 (13.9 to 54.9) | 397/482 | 82.4 (78.7 to 85.7) |
| Malodorous smell | 5/91 | 5.5 (1.8 to 12.4) | 408/412 | 99.0 (97.5 to 99.7) | 5/9 | 55.6 (21.2 to 86.3) | 408/494 | 82.6 (79.0 to 85.8) |
| Vaginal discharge | 11/93 | 11.8 (6.1 to 20.2) | 371/413 | 89.8 (86.5 to 92.6) | 11/53 | 20.8 (10.8 to 34.1) | 371/453 | 81.9 (78.0 to 85.3) |
| Any symptoms | 26/93 | 28.0 (19.1 to 38.2) | 321/417 | 77.0 (72.6 to 80.9) | 26/122 | 21.3 (15.0 to 29.7) | 321/388 | 82.7 (78.6 to 86.4) |
| Candida albicans | ||||||||
| Heavy menstruation | 4/44 | 9.1 (2.5 to 21.7) | 435/463 | 94.0 (91.4 to 95.9) | 4/32 | 12.5 (3.5 to 29.0) | 435/475 | 91.6 (88.7 to 93.9) |
| Between menses bleeding | 1/44 | 2.2 (0.1 to 12.0) | 444/563 | 95.9 (93.7 to 97.5) | 1/20 | 5.0 (0.1 to24.9) | 444/487 | 91.2 (88.3 to 93.5) |
| Burning urine | 0/44 | 0.0 (0.0 to 8.4) | 452/463 | 97.6 (95.8 to 98.8) | 0/11 | 0.0 (0.0 to 28.5) | 452/496 | 91.1 (88.3 to 93.5) |
| Frequency of urine | 0/44 | 0.0 (0.0 to 8.0) | 451/463 | 97.4 (95.5 to 98.7) | 0/12 | 0.0 (0.0 to 26.5) | 451/495 | 91.1 (88.3 to 93.5) |
| Abdominal/vaginal pain | 6/44 | 13.6 (5.2 to 27.9) | 424/463 | 91.6(88.7 to 93.9) | 6/45 | 13.3 (5.5 to 26.8) | 424/462 | 91.8 (88.9 to 94.1) |
| Pain during intercourse | 0/8 | 0.0 (0.0 to 36.9) | 36/38 | 94.7 (82.3 to 99.4) | 0/2 | 0.0 (0.0 to 84.2) | 36/44 | 81.8 (67.3 to 91.8) |
| Itchy/sore vagina | 1/44 | 2.3 (0.1 to 12.0) | 437/457 | 95.6 (93.3 to 97.3) | 1/21 | 4.8 (0.1 to 23.8) | 437/480 | 91.0 (88.1 to 93.4) |
| Malodorous smell | 0/42 | 0.0 (0.0 to 8.4) | 450/458 | 98.3 (96.6 to 99.2) | 0/8 | 0.0 (0.0 to 36.9) | 450/492 | 91.5 (88.6 to 93.8) |
| Vaginal discharge | 3/43 | 7.0 (1.4 to 19.1) | 410/460 | 89.1 (85.9 to 91.8) | 3/53 | 5.7 (1.2 to 15.7) | 410/450 | 91.1 (88.1 to 93.6) |
| Any symptoms | 11/44 | 25.0 (13.2 to 40.3) | 354/463 | 76.5 (72.3 to 80.3) | 11/120 | 9.2 (4.7 to 15.8) | 354/387 | 91.1 (88.2 to 94.1) |
| Chlamydia trachomatis | ||||||||
| Heavy menstruation | 0/13 | 0.0 (0.0 to 24.7) | 461/494 | 93.3 (90.6 to 95.4) | 0/33 | 0.0 (0.0 to 10.6) | 461/474 | 97.3 (95.4 to 98.5) |
| Between menses bleeding | 0/13 | 0.0 (0.0 to 24.7) | 475/494 | 96.2 (94.1 to 97.7) | 0/19 | 0.0 (0.0 to 17.7) | 475/488 | 97.3 (95.5 to 98.6) |
| Burning urine | 1/13 | 7.7 (0.2 to 36.0) | 484/494 | 98.0 (96.3 to 99.0) | 1/11 | 9.1 (0.2 to 41.3) | 484/496 | 97.6 (95.8 to 98.8) |
| Frequency of urine | 0/13 | 0.0 (0.0 to 24.7) | 481/494 | 97.4 (95.5 to 98.6) | 0/13 | 0.0 (0.0 to 24.7) | 481/494 | 97.4 (95.5 to 98.6) |
| Abdominal/vaginal pain | 2/13 | 15.4 (1.9 to 45.5) | 451/494 | 91.3 (88.5 to 93.6) | 2/45 | 4.4 (0.5 to 15.2) | 451/462 | 97.6 (95.8 to 98.8) |
| Pain during intercourse | 0/1 | 0.0 (0.0 to 97.5) | 43/45 | 95.6 (84.9 to 99.5) | 0/2 | 0.0 (0.0 to 84.2) | 43/44 | 97.7 (88.0 to 99.9) |
| Itchy/sore vagina | 1/13 | 7.7 (0.2 to 36.0) | 467/488 | 95.7 (93.5 to 97.3) | 1/22 | 4.6 (0.1 to 22.8) | 467/479 | 97.5 (95.7 to 98.7) |
| Malodorous smell | 0/13 | 0.0 (0.0 to 24.7) | 478/487 | 98.2 (96.5 to 99.2) | 0/9 | 0.0 (0.0 to 33.6) | 478/491 | 97.4 (95.5 to 98.6) |
| Vaginal discharge | 2/13 | 15.4 (1.9 to 45.5) | 439/490 | 89.6 (86.5 to 92.2) | 2/53 | 3.8 (0.5 to 13.0) | 439/450 | 97.6 (95.7 to 98.8) |
| Any symptoms | 4/13 | 30.8 (9.1 to 61.4) | 377/494 | 76.3 (72.3 to 80.0) | 4/121 | 3.3 (0.9 to 8.3) | 377/386 | 97.7 (95.6 to 98.9) |
| Trichomonas vaginalis | ||||||||
| Heavy menstruation | 1/12 | 8.3 (0.2 to 38.5) | 464/495 | 93.4 (90.8 to 95.4) | 1/32 | 2.9 (0.1 to 15.3) | 464/475 | 97.7 (95.9 to 98.8) |
| Between menses bleeding | 0/12 | 0.0 (0.0 to 26.5) | 475/495 | 96.0 (93.8 to 97.5) | 0/20 | 0.0 (0.0 to 16.8) | 475/487 | 97.5 (95.7 to 98.7) |
| Burning urine | 1/12 | 8.3 (0.2 to 38.5) | 485/495 | 98.0 (96.3 to 99.0) | 1/11 | 9.1 (0.2 to 41.3) | 485/496 | 97.8 (96.1 to 98.9) |
| Frequency of urine | 0/12 | 0.0 (0.0 to 26.5) | 483/495 | 97.6 (95.8 to 98.7) | 0/12 | 0.0 (0.0 to 26.5) | 483/495 | 97.6 (95.8 to 98.7) |
| Abdominal/vaginal pain | 2/12 | 16.7 (2.1 to 48.4) | 452/495 | 91.3 (88.5 to 93.6) | 2/45 | 4.4 (0.5 to 15.2) | 452/462 | 97.8 (96.1 to 99.0) |
| Pain during intercourse | 2/2 | 100 (15.8 to 100) | 44/44 | 100 (92.0 to 100) | 2/2 | 100 (15.8 to 100) | 44/44 | 100 (92.0 to 100) |
| Itchy/sore vagina | 1/12 | 8.3 (0.2 to 38.5) | 469/489 | 95.9 (93.8 to 97.5) | 1/21 | 4.8 (0.1 to 23.8) | 469/480 | 97.7 (95.9 to 98.9) |
| Malodorous smell | 2/12 | 16.7 (2.1 to 48.4) | 482/488 | 98.8 (97.3 to 100) | 2/8 | 25.0 (3.2 to 65.1) | 482/492 | 98.0 (96.3 to 100) |
| Vaginal discharge | 2/12 | 16.7 (2.1 to 48.4) | 440/491 | 89.6 (86.6 to 92.2) | 2/53 | 3.8 (0.5 to 13.0) | 440/450 | 97.8 (96.0 to 98.9) |
| Any symptoms | 6/12 | 50.0 (21.1 to 78.9) | 381/495 | 77.0 (73.0 to 80.6) | 6/120 | 5.0 (1.9 to 10.6) | 381/387 | 98.5 (96.7 to 99.4) |
| Neisseria gonorrhoeae* | ||||||||
| Heavy menstruation | 1/3 | 33.3 (0.8 to 90.6) | 472/504 | 93.7 (91.2 to 95.6) | 1/33 | 3.0 (0.1 to 15.8) | 472/474 | 99.6 (98.5 to 100) |
| Between menses bleeding | 1/3 | 33.3 (0.8 to 90.6) | 486/504 | 96.4 (94.4 to 97.9) | 1/19 | 5.3 (0.1 to 26.0) | 486/488 | 99.6 (98.5 to 100) |
| Burning urine | 1/3 | 33.3 (0.8 to 90.6) | 494/504 | 98.2 (96.4 to 99.0) | 1/11 | 9.1 (0.2 to 41.3) | 494/496 | 99.6 (98.6 to 100) |
| Frequency of urine | 0/3 | 0.0 (0.0 to 70.6) | 491/504 | 97.4 (95.6 to 98.6) | 0/13 | 0.0 (0.0 to 24.7) | 491/494 | 99.4 (98.6 to 99.9) |
| Abdominal/vaginal pain | 1/3 | 33.3 (0.8 to 90.6) | 460/504 | 91.3 (88.5 to 93.6) | 1/45 | 2.2 (0.1 to 11.8) | 460/462 | 99.6 (98.5 to 100) |
| Itchy/sore vagina | 1/3 | 33.3 (0.8 to 90.6) | 477/498 | 95.8 (93.6 to 97.4) | 1/22 | 4.6 (0.1 to 22.8) | 477/479 | 99.6 (98.5 to 100) |
| Malodorous smell | 0/3 | 0.0 (0.0 to 70.7) | 488/497 | 98.2 (96.6 to 99.1) | 0/9 | 0.0 (0.0 to 33.6) | 488/491 | 99.4 (98.2 to 100) |
| Vaginal discharge | 1/3 | 33.3 (0.8 to 90.6) | 448/500 | 89.6 (86.6 to 92.1) | 1/53 | 1.9 (0.1 to 10.1) | 448/450 | 99.6 (98.4 to 100) |
| Any symptoms | 2/3 | 66.7 (9.4 to 99.1) | 385/504 | 76.4 (72.3 to 80.0) | 2/121 | 1.9 (0.2 to 5.8) | 385/386 | 99.7 (98.6 to 100) |
*Pain or bleed during intercourse was limited to 46 girls responding to symptoms of pain or bleeding during sexual intercourse (no data for N. gonorrhoeae).
†4–6 girls did not answer questions on vaginal itching, smell, discharge.
NPV, negative predictive value; PPV, positive predictive value.